A combination of mobile technology and remote coaching holds promise in encouraging healthier eating and physical activity, say researchers at the National Institutes of Health who examined the best way to change multiple health behaviors in adults. Free, full text of the article is available in Archives of Internal Medicine.

The scientists studied 204 adults who were overweight or obese and had a diet high in saturated fat and low in fruits and vegetables. The participants also engaged in little daily physical activity and had high amounts of sedentary leisure time.

Each participant was assigned to 1 of 4 groups:

increase fruit and vegetable intake and increase time in moderate/vigorous physical activity

increase fruit and vegetable intake and reduce time in sedentary leisure activities

decrease fat intake and increase time in moderate/vigorous physical activity

decrease fat intake and decrease time in sedentary leisure activities

Participants received mobile devices and were trained on entering information about their daily activities and eating patterns. Coaches studied the data received and then phoned or e-mailed participants to encourage and support healthy changes during the 3-week study. Participants also were asked to continue to track and submit their data over a 20-week follow-up period. Financial incentives for reaching study goals during the study and continuing participation during the follow-up period were offered.

All 4 groups showed improvements in reaching the assigned health goals, with the most striking results occurring in the group asked to increase fruit and vegetable intake and reduce sedentary leisure activities. After 20 weeks, this group's average daily servings of fruits and vegetables increased from 1.2 to 2.9. The group's average minutes per day of sedentary leisure activity dropped from 219.2 to 125.7, and the percentage of saturated fat in daily calories went from 12 to 9.9.

"Via technology, we will soon be able to deliver fully automated and configurable multiple risk factor interventions that monitor progress continuously and can be delivered throughout the day every day," William T. Riley, PhD, says in accompanying commentary on the study. "It remains an empirical question, however, whether these technological advances improve outcomes, reduce costs, or both."